Healthcare Provider Details

I. General information

NPI: 1912952896
Provider Name (Legal Business Name): DECATUR EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 SOMERVILLE RD SE
DECATUR AL
35601-4334
US

IV. Provider business mailing address

PO BOX 303
GADSDEN AL
35902-0303
US

V. Phone/Fax

Practice location:
  • Phone: 256-547-6119
  • Fax: 256-546-2981
Mailing address:
  • Phone: 256-547-6119
  • Fax: 256-546-2981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number050110
License Number StateAL

VIII. Authorized Official

Name: DR. ROGER D STANMORE
Title or Position: OWNER
Credential: M.D.
Phone: 256-547-6119